ESIS Supervisor, SIU
Job Location:
Philadelphia, PA - USA
Yearly Salary:
Posted:
Application Deadline:
Vacancies:
Job Summary
The SIU Supervisor is responsible for overseeing the daily operations of the Special Investigations Unit (SIU) ensuring the delivery of high-quality fraud investigation services across all lines of business. This role provides technical leadership manages vendor partner relationships ensures compliance with state regulatory requirements and SIU best practices and drives revenue and quality performance results. The SIU Supervisor reports to the SIU SVP and serves as a key liaison between internal claims operations external clients account executives and vendor partners.
Quality & Technical Performance
Achieve and maintain quality results that consistently meet or exceed established SIU Best Practices.
Contribute to achieving the annual SIU revenue goal by driving effective fraud detection and cost containment outcomes.
Ensure SIU compliance with Best Practices and applicable controls.
Maintain an aged job queue and diary where no item exceeds 7 days from the current date; apply appropriate diary cycles to each case based on its development.
Ensure accurate and timely management of the OFAC screening process and provide guidance as required.
Proactively identify trends impacting quality and workflows and recommend process improvements to leadership.
Harbor and coordinate relationships with the Department of Insurance District Attorneys and the Attorney General agencies to include gathering claim request for copies of documents which include coordination with our internal counsel.
Reporting & Analytics
Review all carrier and client data call reports in a timely manner (annual quarterly monthly and weekly).
Distribute accurate and timely audit metrics to carriers clients and internal customers.
Provide monthly performance and trend reports to the SIU SVP summarizing results positive and negative findings and recommended next steps.
Responsible for weekly monthly and quarterly financial reporting to both internal and external stakeholders.
Vendor Management
Cultivate strong relationships with SIU vendor partners to ensure accountability to account Service Level Agreements (SLAs).
Perform vendor Quality Reviews and develop action plans as required conduct follow-up calls with any vendor.
Evaluate monthly data provided by vendor partners for accuracy and identify opportunities for improvement in reporting and quality.
Review vendor invoices and reports for quality and accuracy to ensure work product meets client and claims handler expectations.
Continue to identify new revenue-generating products available through internal and external SIU resources (e.g. SSN death indicator research social media research tools).
Stakeholder Relations & Customer Service
Maintain solid business relationships with key internal and external contacts including ESIS claims offices Sales staff clients and Account Executives.
Respond promptly to client and Account Executive inquiries; maintain open-door and open-phone policy with all internal and external teams.
Monitor referral trends from ESIS claims offices (APL & WC) and determine if SIU refresher training is needed; develop and initiate training programs as required.
Comply with all SAS SIU instructions and established protocols when interacting with internal and external clients.
Develop and maintain solid business relationships with key clients claim staff and Account Executives.
Training
Maintain training documents andprovide and coordinatetraining including annual fraud awareness training new hire onboarding and ad hoc requests.
Monitor referral trends from claims offices to proactively identify SIU refresher training needs and develop targeted programs accordingly.
Share gained knowledge with the broader team to foster continuous learning and professional development.
Qualifications
57 years of SIU or related insurance claims investigation experience preferred.
Strong understanding of insurance fraud detection across all lines of business (APL Workers Compensation and others).
Proven ability to manage vendor relationships promoting effective communication with all internal and external parties.
Strong analytical reporting and file review skills.
Excellent interpersonal coaching and leadership skills with commitment to team development.
Strong organizational skills with the ability to manage competing priorities across a multi-state region.
Demonstrated ability to maintain compliance with state regulatory mandates and SIU best practices.
Proficiency in claims management systems and SIU databases; experience with ECOS WorkView or similar platforms is a plus.
Strong written and verbal communication skills.
Ability to remain positive open-minded and adaptable in a dynamic fast-paced environment.
The pay range for the role is $85800 to $123200. The specific offer will depend on an applicants skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.
Required Experience:
Manager
About Company
Chubb Life has been in Egypt since 2003. Chubb Life is the international life insurance division of Chubb - the world's largest publicly traded property and casualty insurance company by market capitalization.
